Presenting author biography:

Elisabeth AVRIL is GP and director of Gaia Paris association whose missions are developing HR among PWUD. As a clinician, she is involved in the HIV and HVC treatment of PWUD and substitution therapy. She has implemented the mobile Fibroscan project. Gaia Paris runs also the first DCR in France.

Opening of the first drug consumption room in Paris: 7 years of a constant involvement

Elisabeth Avril, Celine Debaulieu, josé MATOS, Thomas DUSOUCHET

Issue: An open drug scene around the north train station in Paris has been developing for 10 years. Needs have been identified since 2006, by NSP mobile unit of Gaia. Around 3000 PWUD are coming to buy and to use drugs in the area.

Setting: The scene takes place in the north-east of Paris, one of the biggest hub of the region with the busiest train station in Europe and a major hospital. The DCR is located within the premises of the hospital Lariboisière with a separate entrance. Our clients are mostly marginalized, vulnerable,and live in precarious conditions (60% are homeless) with poor access to healthcare. They mostly inject morphine sulfate (tablets), smoke crack and drink alcohol.

Process: After several years of associative and community mobilization, the mayor of the 10th district of Paris has included the DCR project in his 2014 electoral campaign. The health ministry, the regional health agency and various stakeholders have also supported the project. The new Public Health law, adopted in January 2016, included an article allowing a 6 years experiment of DCRs.
The DCR, designed with 3 different spaces (welcoming/waiting room, consumption room and resting area) is open 7/7 days from 1:30PM to 8:30PM. The team consists of nurses, social workers, GPs and security agents.

Outcomes: The DCR was inaugurated in October 11th by the Minister of Health and the Mayor of Paris. The DCR can welcome around 400 consumptions (about 150 clients) per day. The expected impacts are focused on public health and less discarded syringes and drug use in public areas. A change is expected in the law enforcement practices after several sessions of sensitization towards police officers. We faced various barriers, such as legal, political, social (neighborhood) and financial barriers.